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dc.contributor.authorLee, Puikwanen
dc.contributor.authorGreenfield, Gevaen
dc.contributor.authorPappas, Yannisen
dc.date.accessioned2018-09-21T10:53:41Z
dc.date.available2018-09-21T10:53:41Z
dc.date.issued2018-06-26
dc.identifier.citationLee P, Greenfield G, Pappas Y (2018) 'The impact of telehealth remote patient monitoring on glycemic control in type 2 diabetes: a systematic review and meta-analysis of systematic reviews of randomised controlled trials', BMC Health Services Research, 18 (1), pp.495-.en
dc.identifier.issn1472-6963
dc.identifier.pmid29940936
dc.identifier.doi10.1186/s12913-018-3274-8
dc.identifier.urihttp://hdl.handle.net/10547/622873
dc.description.abstractBackground There is a growing body of evidence to support the use of telehealth in monitoring HbA1c levels in people living with type 2 diabetes. However, the overall magnitude of effect is yet unclear due to variable results reported in existing systematic reviews. The objective of this study is to conduct a systematic review and meta-analysis of systematic reviews of randomised controlled trials to create an evidence-base for the effectiveness of telehealth interventions on glycemic control in adults with type 2 diabetes. Methods Electronic databases including The Cochrane Library, MEDLINE, EMBASE, HMIC, and PsychINFO were searched to identify relevant systematic reviews published between 1990 and April 2016, supplemented by references search from the relevant reviews. Two independent reviewers selected and reviewed the eligible studies. Of the 3279 references retrieved, 4 systematic reviews reporting in total 29 unique studies relevant to our review were included. Both conventional pairwise meta-analyses and network meta-analyses were performed. Results Evidence from pooling four systematic reviews found that telehealth interventions produced a small but significant improvement in HbA1c levels compared with usual care (MD: -0.55, 95% CI: -0.73 to − 0.36). The greatest effect was seen in telephone-delivered interventions, followed by Internet blood glucose monitoring system interventions and lastly interventions involving automatic transmission of SMBG using a mobile phone or a telehealth unit. Conclusion Current evidence suggests that telehealth is effective in controlling HbA1c levels in people living with type 2 diabetes. However there is need for better quality primary studies as well as systematic reviews of RCTs in order to confidently conclude on the impact of telehealth on glycemic control in type 2 diabetes.
dc.language.isoenen
dc.publisherBioMed Central Ltd.en
dc.relation.urlhttps://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3274-8en
dc.rightsGreen - can archive pre-print and post-print or publisher's version/PDF
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectremote healthcareen
dc.subjecttype 2 diabetes mellitusen
dc.subjectblood glucoseen
dc.subjecttype 2 diabetesen
dc.subjectdiabetesen
dc.subjecttelehealthen
dc.subjecttelemedicineen
dc.subjectA300 Clinical Medicineen
dc.titleThe impact of telehealth remote patient monitoring on glycemic control in type 2 diabetes: a systematic review and meta-analysis of systematic reviews of randomised controlled trialsen
dc.typeArticleen
dc.contributor.departmentImperial College Londonen
dc.contributor.departmentUniversity of Bedfordshireen
dc.identifier.journalBMC Health Services Researchen
dc.identifier.pmcidPMC6019730
dc.date.updated2018-09-21T10:03:45Z
dc.description.noteopen access article
html.description.abstractBackground There is a growing body of evidence to support the use of telehealth in monitoring HbA1c levels in people living with type 2 diabetes. However, the overall magnitude of effect is yet unclear due to variable results reported in existing systematic reviews. The objective of this study is to conduct a systematic review and meta-analysis of systematic reviews of randomised controlled trials to create an evidence-base for the effectiveness of telehealth interventions on glycemic control in adults with type 2 diabetes. Methods Electronic databases including The Cochrane Library, MEDLINE, EMBASE, HMIC, and PsychINFO were searched to identify relevant systematic reviews published between 1990 and April 2016, supplemented by references search from the relevant reviews. Two independent reviewers selected and reviewed the eligible studies. Of the 3279 references retrieved, 4 systematic reviews reporting in total 29 unique studies relevant to our review were included. Both conventional pairwise meta-analyses and network meta-analyses were performed. Results Evidence from pooling four systematic reviews found that telehealth interventions produced a small but significant improvement in HbA1c levels compared with usual care (MD: -0.55, 95% CI: -0.73 to − 0.36). The greatest effect was seen in telephone-delivered interventions, followed by Internet blood glucose monitoring system interventions and lastly interventions involving automatic transmission of SMBG using a mobile phone or a telehealth unit. Conclusion Current evidence suggests that telehealth is effective in controlling HbA1c levels in people living with type 2 diabetes. However there is need for better quality primary studies as well as systematic reviews of RCTs in order to confidently conclude on the impact of telehealth on glycemic control in type 2 diabetes.


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